7.03.2012

Mom's Diagnosis: What is Hashimoto's Disease?

2012 is turning out to be a far better year than 2011. My mom does NOT have cancer!!! Thank you to all who prayed and sent good thoughts our way.

Thyroid disease has attacked at least four women in my family and so far we are all strong survivors. Every single one of my mother's eight brothers and sisters has some kind of thyroid ailment, so it was rather unlikely she would escape scott-free. And she hasn't. She was positive for Hashimoto's Thyroiditis. This blog is dedicated to you, Mom, since you asked me to do research on Hashimoto's.

What is Hashimoto's disease?

I went into signs and symptoms a little in my last blog, but did not really discuss the implications of the disease itself. For all the details, read this article. For summary and observations keep reading.

Look at the model on the left. The thyroid on the trachea is an example of what a nice, normal thyroid should look like. The one to the right of it with the ugly red growth is an example of papillary carcinoma in a nodule. The Swollen pink one is Grave's disease. And that really hideous one? The one that's kind of gray-beige in color and looks more like a dog bone than a butterfly? That's the thyroid of us HD patients.

Like other diseases of the thyroid, Hashimoto's is an autoimmune disease that damages thyroid cells. This disease inhibits thyroid hormone production, causing the patient to experience all the glory of hypothyroidism (fatigue, weight gain, sensitivity to cold, muscle pain, etc. (and in extreme cases a tendency to slice your own head open if you believe the "Post Mortem" episode of House. Maybe avoid doctor TV shows after diagnosis; it tends to lead toward paranoia.)).

Unfortunately, the symptoms of hypothyroidism are easy to ignore. Put on weight? Blame that extra piece of birthday cake. Sensitive to cold? You're cold-blooded. Feeling tired? Who isn't?? Most articles on Hashimoto's have a line or two about how it can take years for symptoms to manifest. But even if they are manifesting, you might not be paying attention! Hardly anyone goes to the doctor for achy legs or constipation. People would think you were a hypochondriac. In some ways our societal attitudes towards illness could really stand to be reexamined.

What are the causes of Hashimoto's Disease?

The most obvious cause is genetics. Four cases of it in my family (so far). I was diagnosed with HD at the same time as my cancer, but it was rendered moot by my total thyroidectomy. Like thyroid cancer, this is also a disease that mostly targets women. I've also read that it mostly targets middle-aged women, but I question the usefulness of this statement. I dismissed cancer as a possibility because I was (and still am) in my late twenties, which I don't think is considered middle-aged by anyone old enough to have graduated high school. I don't want others to dismiss the possibility of HD for the same reason. Given the strong correlation between Hashimoto's and Thyroid Cancer, it is likely that you can contract HD in your twenties.

Here are the three most interesting causes: pregnancy, too much iodine or other drugs, and radiation exposure. Apparently pregnancy can cause a number of thyroid illnesses due to increased thyroid hormone or hyperthyroidism. Strangely enough, this has a strong correlation with developing HD post-pregnancy.

Here's the one my mom needs to pay attention to: TOO MUCH IODINE. "Other drugs" refers to iodine supplements or drugs containing iodine. I don't know how this happened, but at some point my mom decided that a lack of iodine is the cause of her hypothyroidism. Unfortunately, she has started taking iodine supplements, which I found highly suspect even prior to researching. I have now found several articles that say NOT to take iodine, including this one, which also argues that iodine supplements are harmful for those who already have Hashimoto's.

Most people in America get PLENTY of iodine. Unless you are a complete health-food junkie who never eats anything other than what you have cooked yourself, you are safe. Here's why: most processed foods have iodine and iodized salts in them. In addition to the LONG list of foods with naturally occurring iodine (as iodide) (meats, grains, eggs, beans, dairy, anything from the sea), the U.S. has a salt iodization program (started in the 1920's), whereby iodide is added to all table salt.

High intakes of iodine can cause some of the same symptoms as iodine
deficiency—including goiter, elevated TSH levels, and
hypothyroidism—because excess iodine in susceptible individuals inhibits
thyroid hormone synthesis and thereby increases TSH stimulation, which
can produce goiter [2,58].
Iodine-induced hyperthyroidism can also result from high iodine
intakes, usually when iodine is administered to treat iodine deficiency.
Studies have also shown that excessive iodine intakes cause thyroiditis
and thyroid papillary cancer [2,58].
Cases of acute iodine poisoning are rare and are usually caused by
doses of many grams. Acute poisoning symptoms include burning of the
mouth, throat, and stomach; fever; abdominal pain; nausea; vomiting;
diarrhea; weak pulse; and coma [2].

And finally, radiation exposure. This mostly refers to anyone who has been exposed to HUGE amounts of radiation, like that of an atomic bomb or nuclear disaster. Radiation is actually naturally occurring and all people produce radiation. Radon is the biggest source of radiation, medical x rays the second, and everything the third. The only one we can do anything about is medical x-rays (and I guess this now includes those taken at airports). I'm not saying to avoid x-rays, but be aware of when they are necessary and when your doctor or dentist is just trying to get a few extra bucks. For instance, getting x-rays every time you get your teeth cleaned is NOT medically necessary. And the thing I learned only AFTER my diagnosis is that you can request a cover for your neck during x-rays, to protect your thyroid!

What are the treatments for Hashimoto's Disease?

Well, Mom, you don't have to be on any sort of special diet. Although you do have to stop taking those darn iodine pills. Sorry. You'll have to avoid donuts for other reasons. Basically, those with HD are put on a thyroid-replacement supplement such as Synthroid or Levothyroxine. It will take a couple of months to get your hormone level balanced.

Occasionally a thyroidectomy is recommended for those with HD. However, unless you are suffering from severe Hashimoto's and medication alone is not helping your symptoms, a thyroidectomy would be a drastic and possibly unnecessary procedure. Of course I am not a doctor. But I understand from thyroid forums and articles such as this one, that "There are a few voices out there that would recommend that all patients with Hashimoto’s Disease undergo thyroidectomy."

Make sure your doctor isn't one of them! Surgery is not fun. I hope I never have surgery again. The only reasons to undergo a thyroidectomy with Hashimoto's are if the scar tissue has built up around your wind pipe, making it difficult to breath or swallow, or if hard nodules have formed that are indistinguishable from thyroid cancer. Even then, I would get a biopsy first.

So that's it. My nutshell description of Hashimoto's Disease, which was named after its discoverer, Hakuru Hashimoto. I leave you with this thought: If you discovered a disease, would you really want it to be named after you?

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Just Cancer is a blog by Mary Noon, writer, artist, and lifelong bibliophile, who was diagnosed with Papillary Thyroid Carcinoma in May 2011. This personal account of her experiences with thyroid cancer exists so that others may know what to expect. She also hopes to raise awareness of what is now the fastest increasing cancer in the U.S.